Now that we have over 20,000 cases, it has become imperative that we are able to more easily find quality cases with confirmed diagnoses. To that end over the next week or two we are introducing a new component to all cases: Diagnostic Certainty (DC).

This new user interface is located immediately below the title in case edit mode.

There are 5 possible levels of diagnostic certainty

Possible

The preferred diagnosis is one of a number of possible diagnoses, and although it is perhaps more likely, other conditions remain viable alternatives. Cases like this are sometimes worthwhile, but often they are not. What you need to do: include a discussion on why you favor your diagnosis. Be prepared for your case to be rejected for publication. That's ok, you can always keep it as one of your unlisted cases.

Probable

The preferred diagnosis is far more likely (>90%) than any alternative, but the diagnosis has not been established.

Confirmed but unsubstantiated

You have reason to believe the diagnosis was confirmed, but you do not have access to the proof and cannot upload it. For example, you collected this case some time ago and have included "path proven" in the description but no actual histology report. Alternatively the referral states the diagnosis which was established elsewhere.

Confirmed and substantiated

The diagnosis is known beyond a doubt and proof is included in this case. For example, histology report +/- slides are included, or confirmatory tests have been provided and those results included. Sometimes images are pathognomonic (e.g. fractures) and need no supportive evidence.

Not applicable

The images are not of a patient with a particular diagnosis. For example, they may be a normal scan for teaching purposes, or alternatively a diagram or flow chart.

How diagnostic certainty is used on the site

The diagnostic certainty of a case has many implications and functions.

Firstly it has a strong influence on case completeness, and therefore sorting search results by case completeness will favor cases with high DC. Similarly these cases will be more frequently shown in Quiz Mode.

Secondly search results will show the DC state as a colored dot (matching the slider).

Thirdly search results can be (soon) filtered to only show cases of a minimum DC (e.g. at least confirmed but unsubstantiated).